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KMID : 0368120100400120632
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Korean Circulation Journal
2010 Volume.40 No. 12 p.632 ~ p.638
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Effect of Lacidipine on Blood Pressure and Endothelial Function in Mild-to-Moderate Essential Hypertension Patients With Diabetes in Korea
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Kim Dae-Hee
Oh Il-Young
Lee Hae-Young
Kim Yong-Jin
Kim Hyo-Soo
Kim Cheol-Ho
Oh Byung-Hee
Kim Kwon-Sam
Kim Doo-Il
Kim Young-Dae
Ryu Kyu-Hyung
Park Si-Hoon
Baek Sang-Hong
Shin Dong-Gu
Shim Wan-Joo
Ahn Tae-Hoon
Oh Seok-Kyu
Lee Seung-Hwan
Lee Sung-Yun
Jeong Myung-Ho
Chung Wook-Sung
Jeong Jun-Young
Choi So-Yeon
Choi Si-Wan
Hyon Min-Su
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Abstract
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Background and Objectives: The aim of this study was to evaluate the efficacy of lacidipine in reducing blood pressure (BP) and to determine its effect on endothelial function in mild-to-moderate hypertensive patients with type 2 diabetes mellitus (DM).
Subjects and Methods: This was a prospective, multicenter, open-label, single-arm study, enrolling 290 patients with mild-to-moderate hypertension and type 2 DM. Patients were initially treated with 2 mg lacidipine orally once daily for 4 weeks, which was then increased as necessary every 4 weeks to a maximal dose of 6 mg daily. The primary endpoint was the mean change in systolic blood pressure (SBP) from baseline after 12 weeks of treatment. Secondary endpoints included mean changes in diastolic blood pressure (DBP), flow-mediated vasodilatation (FMD), and serum concentrations of biochemical markers such as high-sensitivity C-reactive protein (hs-CRP), monocyte chemo-attractant protein-1 (MCP-1), matrix metalloproteinase-9 (MMP-9), and plasminogen activator inhibitor-1 (PAI-1).
Results: Lacidipine treatment significantly reduced SBP by -13.4±13.0 mmHg (p<0.001) and DBP by -6.2±9.3 mmHg (p<0.001). Lacidipine treatment did not improve endothelial-dependent vasodilatation, despite significantly improved nitroglycerin-induced, endothelial-independent vasodilatation. MCP-1 levels significantly decreased from 283.66±110.08 pg/mL to 257.83±100.23 pg/mL (p<0.001); whereas there were no significant changes in the levels of hs-CRP, MMP-9, or PAI-1.
Conclusion: Twelve weeks of treatment with lacidipine was effective and well tolerated in mild-to-moderate hypertensive patients with type 2 DM. In spite of inducing a significant reduction in MCP-1 levels, lacidipine did not improve endothelial function.
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KEYWORD
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Lacidipine, Diabetes mellitus, Hypertension, Endothelium
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